Combined Perfusion and Permeability Imaging Reveals Different Pathophysiologic Tissue Responses After Successful Thrombectomy

• DOI: 10.1007/s12975-020-00885-y
• Publication Date: 2021-01-12T20:00:50Z
• Authors: Arne Potreck; Matthias A. Mutke; Charlotte S. Weyland; Johannes A. R. Pfaff; Peter A. Ringleb; Sibu Mundiyanapurath; Markus A. Möhlenb...; Sabine Heiland; Mirko Pham; Martin Bendszus; Angelika Hoffmann
• Keywords: Pathophysiology; Neuroradiology; Vascular surgery

Abstract Despite successful recanalization of large-vessel occlusions in acute ischemic stroke, individual patients profit to a varying degree. Dynamic susceptibility-weighted perfusion and dynamic T1-weighted contrast-enhanced blood-brain barrier permeability imaging may help determine secondary stroke injury predict clinical outcome. We prospectively performed 38 within 24 h after mechanical thrombectomy an occlusion the middle cerebral artery M1 segment. Perfusion alterations were evaluated on blood flow maps, disruption (BBBD) visually quantitatively k trans maps hemorrhagic transformation images. Visual BBBD DWI lesion corresponded median elevation (IQR) 0.77 (0.41–1.4) min −1 was found all 7 cases hypoperfusion (100%), 10 16 hyperperfusion (63%), only three 13 with unaffected (23%). significantly associated ( p < 0.001). While alone not predictor outcome at 3 months (positive predictive value (PPV) = 0.8 [0.56–0.94]), occurred more often unfavorable (PPV 0.43 [0.10–0.82]) compared 0.93 [0.68–1.0]) or 1.0 [0.75–1.0]). show that combined reveals distinct infarct signatures recanalization, indicating severity prior damage. It assists predicting identify risk progression.